NPIMap

Organization Active NPI

Professional Opticians of NC Inc

  • Eyewear Supplier
  • Fayetteville, NC
National Provider Identifier
1144508672
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
1920 Issued in NC
Legal business name
PROFESSIONAL OPTICIANS OF NC INC
Practice address
1635 Owen Dr
Fayetteville, NC 28304-3425
Phone
(910) 483-0548
Fax
(910) 483-6628
NPI assigned
Aug 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michele L Bellis
Title
Secretary
Phone
(910) 483-0548

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 1920 NC Primary

Addresses

Primary practice location

1635 Owen Dr
Fayetteville, NC 28304-3425

Mailing address

1635 Owen Dr
Fayetteville, NC 28304-3425
Phone (910) 483-0548

Other identifiers 1

IdentifierTypeStateIssuer
8801782MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312243200000",
    "number": "1144508672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043425",
            "telephone_number": "910-483-0548",
            "fax_number": "910-483-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 OWEN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283043425",
            "telephone_number": "910-483-0548",
            "fax_number": "910-483-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL OPTICIANS OF NC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-02",
        "last_updated": "2011-08-02",
        "status": "A",
        "authorized_official_last_name": "BELLIS",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "910-483-0548"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NC",
            "license": "1920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8801782",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.